Aspectos do problema das cáries dentárias no Estado do Amazonas

The problem of dental caries in Manaus, Amazonas, is discussed. Results are presented showing 77.7% incidence in 193 children between one and eight years of age. The factors involved in the evolution of dental caries are described and possible means of atacking the problem considered. The fluoridization of the local water supplies will only reach more priveleged sectors of the population in urban areas. The possibility of using a vehicle such as salt in order to benefit more of the population should be investigated. Promotion of breast feeding at least in the first weeks of life should be stimulated.São apresentados dados sobre a incidência de cáries em 193 crianças pobres de 1 a 8 anos de idade em Manaus, Amazonas, 1976. A incidência de cáries foi de 77,7%, sendo que no grupo etário de 8 anos atingiu a 97,9%. Possíveis fatores locais envolvidos na evolução das cáries e as possíveis medidas a serem tomadas são discutidos. São enfatizadas a inapropriedade do tratamento dentário conservador e a essencialidade de medidas preventivas nesta área tão grande mas esparsamente povoada. A promoção da amamentação sobre a alimentação artificial nas primeiras semanas de vida da criança e a fluoretação do sal, são sugeridas como medidas práticas de mínimo custo e máximo alcance na redução das cáries em populações rurais e urbanas da Bacia Amazônica

Nutrição em lactentes de um bairro de Manaus, Amazonas ()

In the months of May and June 1976, a study was made of the feeding patterns, nutritional and health status of 82 children in the first year of life in Manaus, Amazonas. Almost half of the children were considered to be suffering differing degrees of malnutrition accompanied by high indices of infection. A high proportion of the children had low birth weights, suggesting significant levels of intrauterine growth retardation and maternal malnutrition. Contributory factors were considered to be early substitution of breast milk for artificial milk, a lack of mother and child health care services and nutritional orientation. Of the few mothers who received nutritional advice, the majority received advice incompatible with their socio-economic and educational status.O estado nutricional, padrões alimentares, infecções intestinais e respiratórias foram verificados em 82 crianças no primeiro ano de vida de uma população urbana de Manaus Amazonas, nos meses de maio e junho de 1976. Alto índice de desnutrição acompanhado de alta morbilidade foi encontrado. Constatou-se também alta taxa de recém-nascidos de baixo peso, sugerindo uma freqüência elevada de desnutrição intra-útero. Os fatores predisponentes mais importantes foram atribuídos à substituição precoce da amamentação pelo leite artificial, à falta de orientação ou orientação errônea das mães compreendendo a ausência total de uma puericultura dirigida às condições sócio-econômicas da região

Estudo antropométrico e clínico do estado nutricional em um grupo de crianças pré-escolares de Manaus, 1976 ()

A clinical and anthropometric evaluation of nutritional status in 122 poor pre-school children in Manaus, showed that 66,4% of the children were suffering from different grades of malnutrition. Clinical signs associated with deficiencies of Vitamin A and Iron indicate the necessity for the further study of these problems. The synergistic roles of infection and nutrition in growth are discussed.Exame físico e medidas antropométricas foram realizados em 122 crianças pré-escolares de Manaus. O estudo foi efetuado numa instituição que abriga crianças pobres, em regime de semi-internato, possibilitando aos pais trabalharem fora. Alto índice de desnutrição foi encontrado, acompanhado de sinais de carência de Vitamina A e anemia. A incidência de cáries dentárias também foi alta nesse inquérito

Consumo de alimentos e alguns nutrientes em Manaus, Amazonas. 1973-4 ()

In view of the scarcity of literature on food consumption and nutrient intakes in the Amazon Basin, the results of a household expenditure survey conducted in 1,200 families of Manaus in 1973-74 were analyzed. The frequency of families buying different foods and the daily per caput intake of these foods, were calculated. The diet was characterized by low vegetable, low legume, low fruit, high bread, high cassava flour and high fish consumption. Using food composition tables, daily per capita intakes of energy, protein, fat, carbohydrate, calcium, iron, vitamina A, riboflavin, thiamin, niacin and ascorbic, acid were estimated and compared with calculated recommendei intakes per capita. Sufficiences of Vitamin and mineral intake; in the medium wage group, considered the sample most representative of the city as a whole, were vitamin A 70,1%, thiamin 76,7%. riboflavine 77,5%, calcium 91,5% iron 154,2%, niacin 155,0% and ascorbic acid 155,6%. These results are worse than those reported for some state capitals of the north-east of Brazil, where malnutrition is considered to be endemic. These deficiencies need corroboration by analasis of local foods and clinical biochemical studies of the local population. The intake of protein and energy seems sufficient since 201% of protein requirements and 92,1% of energy requirements are met. Using the body mass index in the adult population group, obesity is indicated as not being uncommon, especially in middle aged women. The distribution of energy sources as 61,5% fron carbohydrates, 21,3% from fats and 17,2% fron protein would seem satisfactory in relation to recent recommendations of governments of developed countries, where obesity and atherosclerosis are the major public health problems. Based on the food consumption pattern a programme to stimulate production and consumption of vegetables should probably be the main government priority to improve the local food and nutrition situation.Dados de consumo de alimentos e ingestão de nutrientes na Amazônia são escassos. Foram analisados dados já existentes da Primeira Pesquisa sobre Orçamentos Familiares feita entre 1.200 famílias de Manaus, em 1973 e 1974, pela CODEAMA. A dieta caracteriza-se pelo baixo consumo de verduras, legumes, frutas e leguminosas secas, além do alto consumo de peixe, pão e farinha de mandioca. Do ponto de vista quantitativo a dieta parece suficiente ao nível familiar, mas em termos qualitativos é deficiente, com níveis baixos de Vitaminas A e B. Medidas e políticas capazes de melhorar esse quadro em relação aos problemas de Saúde Pública atuais e futuros, são discutidas

Departamento de Ciências Médicas

O Departamento Médico do INPA nasceu com o Instituto, em 27 de julho de 1954. Desde aquela data tem se dirigido a estudo dos problemas de saúde do homem da Amazônia. O histórico do Departamento é relatado, destacando três fases de atuação nas épocas dos DiretoresDjalma Batista, Paulo de Almeida Machado e Warwick Estevan Kerr. Os trabalhos são revisados em três áreasestudos sobre os agentes das doenças da Amazôniaestudos sobre os vetores dos parasitas (sendo destacados os trabalhos de Nelson Cerqueira, sobre a transmissão da Mansonella ozzardi); e estudos relacionados ao homem. Conclui com a contribuição do Departamento ao desenvolvimento da Medicina Tropical e Saúde da Amazônia

Padrão alimentar e consumo de zinco, vitamina A e ferro, em pré-escolares num bairro pobre de Manaus, 1979

With the aim of developing a food education and supplementation project for pre-school children, a survey was undertaken during the school holiday of a poor periurban Manaus pre-school. The food intake during the previous twenty four hours of 153 pre-school children was estimated by interviewing the mothers. The food pattern proved to be limited with a high frequency of consumption of fish bread, biscuits, butter, rice and cassava flour and a low frequency of consumption os pulses, vegetable and fruits. In analyzing the mean nutrient adequacy of zinc, vitamin A and iron, only zinc intake proved to be less than the recommended level. Income showed little significant effect on nutrient intakes. The importance of these findings is discussed and recomendations for a food education and supplementation project made.Um inquérito alimentar foi realizado em 153 pré-escolares, para verificação do padrão alimentar e consumo de zinco, vitamina A e ferro, na dieta. O estudo foi realizado num bairro pobre de Manaus, com alunos da Pré-Escola Abelhinha-INPA. Foi encontrado um padrão alimentar não só limitado e monótono com insuficiência na ingestão de zinco mas também um consumo adequado de vitamina A e ferro. Os resultados são discutidos e as sugestões para um futuro esquema de suplementação e educação nutricional para os pré-escolares da Amazônia são feitas

Impact of a Social Marketing Campaign Promoting Dark-green Leafy Vegetables and Eggs in Central Java,Indonesia

In order to work towards further reduction of vitamin A deficiency in central Java, Indonesia, a social marketing campaign promoting eggs and dark-green leafy vegetables was initiated in March 1996. The nutritional surveillance system (December 1995- December 1996) found the following. The campaign's messages were well noticed. Consumption of at least one egg in the past week increased from 80% to 92% in mothers and from 78% to 92% in children 1236 months old. It increased in all socio-economic groups and was independent of ownership of chickens. Most eggs had been purchased. The quantity of vegetables prepared increased from 93 to 111 g/person daily and most was purchased. Vitamin A intake increased from 335 to 371 RE/d for mothers and from 130 to 160 RE/d for children. Serum retinol levels increased after the start of the campaign, and were related to egg consumption and vitamin A intake. Because 1. data were collected in such a way that respondents were not aware of the link between data collected and the campaign, and 2. vitamin A status increased and was related to increased consumption of eggs and vitamin A intake, we conclude that the social marketing campaign was successful

Estudos nutricionais das populações rurais da Amazônia. I - Várzea do rio Solimões

In the absense of any previous published data on the nutritional status of people living in the rural areas of the Amaon a nutrition survey was performed on a riverside population inhabiting the fertile varzea of the River Solimões. The study area included the banks of two hundred kilometers of river between the town of Coari and the mouth of the River Purus, in the State of Amazonas, Brasil. Every one in ten houses was visited and fifty nine mothers and their one hundred and thirty nine children under six years of age were interviewed and examined. Results are presented concerning the literacy, hygienic and sanitary conditions, child mortality and morbidity, infant feeding, twenty four hour dietary history and food tabus of the mothers and clinical, anthropometric and biochemical findings in the children of the population studied. Infant mortality was 76.4 per thousand a low figure, considering the high rate of maternal illiteracy, lack of hygiene and sanitary concepts, probably related to the protective effects of breast feeding which the majority of children benefited from in the first six months of life. Whilst infant foods were introduced for the majority of children in this period, breast milk was not substituted but was supplemented or complemented and was nearly always offered on demand without any schedule. On average breast feeding lasted thirteen months. Diarrhoea was found in 27.3% of the children in their first year of life, affecting only 14% in the first semester against 50% in the second semester. In the subsequent age groups diarrhoea was found in approximally 25% of the children at the time of the examination. Wasting was most prominent in the first year of life affecting 25% in the second semester. Stunting increased gradually from 15% in the first semester until 80% in the fourth year. Clinical signs possibly associated with vitamin A deficiency were noted in 20% and riboflavin deficiency in 25% of the children. Biochemical evidence of iron deficiency anemia was found in 70% and dental caries in 47% of the children examined. The adult diet appears to be based on fish and cassava flour with little cereal, legume or vegetable consumption. Fifteen percent of the women reported having eaten game in the last twenty four hours whilst the consumption of wild fruits was a little more frequent. Food tabus were reported more commonly in lactation than pregnancy and related mostly to the avoidance of fish and preference for meat during this period.Um Inquérito nutricional foi realizado em 59 famílias da área rural ribeirinha do rio Solimões. As mães foram entrevistadas e cento e quarenta crianças de 0-5 anos dessas mães foram examinadas clinicamente e medidas quanto ao peso e estatura. As principais conclusões são de que as condições higiênico-educacionais locais são precárias. A mortalidade infantil média atinge 76,4/1000 nascidos vivos. A amamentação é prolongada, porém a suplementação alimentar é bastante precoce, com 81,3% das mães introduzindo alimentos infantis no 1.º trimestre. A introdução de alimentos adultos na dieta infantil é tardia, ocorrendo após o 1.º ano de vida. A alimentação aduita básica é a farinha de mandioca, peixe e alguma carne de caça, sendo o consumo de vegetais, legumes e frutas escasso. O estudo nutricional dessas crianças revelou que a anemia atinge 70% delas, predominando a ferropriva. Cárie dentária foi constatada em 47% das crianças. Sinais clínicos de deficiência de vitamina A e riboflavina, foram concentrados em 20% e 25% das crianças respectivamente. O estudo antropométrico revelou que a desnutrição aguda atinge 10,8% e a desnutrição crônica 59,0% das crianças. A doença diarréica predomina no quadro mórbido local, atingindo, no momento do exame, 27,3% das crianças no 1.° ano de vida. Houve correlação nas crianças da amostra entre a freqüência de antecedentes diarréicos e a desnutrição crônica (P < 0,1)